NAHC President Comments on CMS’ Final Rule on Rebasing

CMS Turns A Deaf Ear to the Pleas of Aged, Infirm, Disabled and Dying Americans

November 25, 2013 03:38 PM

Val J. Halamandaris, president of the National Association for Home Care & Hospice (NAHC) took “sharp exception” to a final rule published last Friday, November 22, 2013 by the Centers for Medicare and Medicaid Services (CMS). The final rule, for the most part, confirmed a proposed rule, issued in July, which will cut the Medicare home health benefit by $22 billion over the next four years.

“Congress asked CMS,” Halamandaris said, “to do a comprehensive evaluation of the home health benefit, to isolate what works and what needs improvement, how to increase access and efficiency, and how to reduce costs while improving the quality of care. CMS did none of this. Instead, all they did was look to impose the largest possible cut —3.5 percent a year — on the Medicare home health benefit. This adds up to 14 percent over the next four years, or a total of $22 billion.”

The National Association for Home Care & Hospice has produced studies showing that the Medicare home health benefit has already endured more than its fair share of cuts. The benefit has been cut a disproportionate $78 billion since 2009. Add in the newly imposed cut and $100 billion in cuts will have been taken from the most popular and most-needed Medicare program. And as a result of these cuts by the end of 2017, 75 percent of Medicare-certified agencies will be forced under water with profit margins of zero or less.

“The clear conclusion is that saving money is more important to CMS than serving those who are so sick they cannot leave home without assistance,” Halamandaris pointed out. “It is obvious that they turned a deaf ear to our pleas on behalf of aged, infirm, disabled, and dying Americans.”

“There is no way,” he continued, “that CMS can claim they did not know their actions would result in regulatory mandated bankruptcies. The regulations issued by CMS are therefore confiscatory, depriving patients of an opportunity to do business with Medicare without due process of law. CMS’s decision has the collateral effect of making it impossible for the states to comply with the Olmstead decision of 1999. In this groundbreaking ruling, the U.S. Supreme Court instructed the states that patients have the right to be cared for at home and that every reasonable option must be examined before patients can be placed in an institution.”

“We regret that CMS did not take action to perfect and improve the Medicare home health benefit,” said Halamandaris. “They had the chance to increase access and cut red tape, to make the program more efficient, and improve care while lowering cost. As a result of this missed opportunity, thousands if not millions of Medicare patients will lose the right to receive home care services. While we are disappointed, we do not intend to stand by and watch the home care community being decimated and patients deprived of their right to receive home care under the law. Congress made the law and only Congress has the power to restrict or limit its application. We intend to appeal to Congress to repair this great injustice. If necessary, we will ask senior and disability groups to join us in bringing a law suit against CMS. Together, we will fight to dismantle the new rules that present unconstitutional obstacles to Medicare patients receiving the home care services to which they are entitled under the law.”